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Risk for Five Forms of Suicidality in Acute Pain Patients and Chronic Pain Patients vs Pain-Free Community Controls

Authors

  • David A. Fishbain MD, FAPA,

    Corresponding author
    1. Departments of Psychiatry,
    2. Neurological Surgery, and
    3. Anesthesiology, Miller School of Medicine, University of Miami, Miami, Florida;
    4. Department of Psychiatry, Miami Veterans Administration Hospital, Miami, Florida;
    5. Rosomoff, Comprehensive Pain & Rehabilitation Center, Douglas Gardens, Miami, Florida;
      David A. Fishbain, MD, FAPA, 1400 NW 10th Avenue (D-79), Miami, FL 33136, USA. Tel: 305-243-4060; Fax: 305-243-4061; E-mail: d.fishbain@miami.edu.
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  • Daniel Bruns PsyD,

    1. Health Psychology Associates, Greeley, Colorado;
    2. Integrated Therapies, Lakewood, Colorado, USA
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    • 1

      Authors of the Battery for Health Improvement 2 test.

  • John Mark Disorbio EdD,

    1. Health Psychology Associates, Greeley, Colorado;
    2. Integrated Therapies, Lakewood, Colorado, USA
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      Authors of the Battery for Health Improvement 2 test.

  • John E. Lewis PhD

    1. Departments of Psychiatry,
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  • Original Research Article

David A. Fishbain, MD, FAPA, 1400 NW 10th Avenue (D-79), Miami, FL 33136, USA. Tel: 305-243-4060; Fax: 305-243-4061; E-mail: d.fishbain@miami.edu.

ABSTRACT

Objectives.  The objective of this study was to determine the risk for five forms of suicidality in rehabilitation acute pain patients (APPs) and rehabilitation chronic pain patients (CPPs) vs pain-free community controls.

Design.  The Battery for Health Improvement 2 was developed utilizing a healthy (pain-free) community sample (N = 1,478), a community patient sample (N = 158), and a rehabilitation patient sample (N = 777). These groups were asked five suicidality questions relating to history of wanting to die, wanting to die because of pain, recent frequent suicide ideation, having a suicide plan, and history of suicide attempt. Of the rehabilitation patients, 326 were identified as being APPs, 341 as being CPPs, and 110 as having no pain.

The risk for affirming each of the five suicidality questions was calculated for rehabilitation APPs, rehabilitation CPPs, and rehabilitation patients without pain utilizing the healthy pain-free community sample as the reference group. In addition, risk was calculated for various subgroups of rehabilitation patients: those with worker's compensation status, with litigation status, and with personal injury status.

Setting.  There are a variety of settings.

Results.  In rehabilitation CPPs the risk for suicidality was greater than community pain-free controls for three suicidality questions: history of wanting to die, recent frequent suicide ideation, and having a suicide plan. Worker's compensation status, litigation status, and personal injury status appeared to increase risk for affirmation of some types of suicidality in CPPs. Rehabilitation APPs were at greater risk for all five suicidality items than the community pain-free controls.

Conclusion.  Rehabilitation CPPs are at greater risk for some forms of suicidality than community pain-free controls. This risk is increased by variables such as worker's compensation status, litigation status, and personal injury status. However, it is yet unclear if these variables actually predict suicidality as this requires further analysis.

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